Provider Demographics
NPI:1790730430
Name:MEMON, JAMIL A (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMIL
Middle Name:A
Last Name:MEMON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2003 GREENWOOD OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2306
Mailing Address - Country:US
Mailing Address - Phone:281-316-7966
Mailing Address - Fax:281-316-7963
Practice Address - Street 1:350 BLOSSOM ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4206
Practice Address - Country:US
Practice Address - Phone:281-316-7966
Practice Address - Fax:281-316-7963
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL7044207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196323301Medicaid
TX196323301Medicaid
TX8F5662Medicare PIN
TX0A0203Medicare PIN
TXH88144Medicare UPIN